The Cardiac Implications of Novel Coronavirus
The ACC lists the following points regarding early cardiac implications from case reports on Wuhan Coronavirus.
• Early case reports suggest patients with underlying conditions are at higher risk for complications or mortality from COVID-19; up to 50 percent of hospitalized patients have a chronic medical illness.
• 40 percent of hospitalized patients with confirmed COVID-19 patients have cardiovascular or cerebrovascular disease.
• In a recent case report on 138 hospitalized COVID-19 patients, 19.6 percent of patients developed acute respiratory distress syndrome.
• 16.7 percent of patients developed arrhythmia; 7.2 percent developed acute cardiac injury.
• 8.7 percent of patients developed shock; 3.6% developed acute kidney injury.
• Rates of complication were universally higher for ICU patients.
• The first reported death was a 61-year-old male, with a long history of smoking, who succumbed to acute respiratory distress, heart failure and cardiac arrest.
• Early, unpublished first-hand reports suggest at least some patients develop myocarditis.
COVID-19 Very Similar to MERS and SARS
COVID-19 is a betacoronavirus, like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and presenting as viral pneumonia with a wide range of acuity, the bulletin states. As of Feb. 12, COVID-19 appears to have greater infectivity rate, but a lower case fatality rate, when compared to SARS and MERS. The ACC noted 99 percent of all coronavirus cases are in mainland China, where despite aggressive containment efforts, case counts continue to rise rapidly. Get up-to-date daily statistics from the World Health Organization (WHO) COVID-19 situation reports.
Additional 2019-nCoV Information Available in the ACC Bulletin
The ACC said 2019-nCoV is a fast-moving epidemic with an uncertain clinical profile and providers should be prepared for guidance to shift as more information becomes available. The ACC said it will be updating the bulletin as appropriate. In addition, ACC has reached out to its partners and colleagues in China expressing its support as they work to address the growing epidemic.
The bulletin includes sections covering:
• Clinical guidance given current COVID-19 uncertainty;
• Potential cardiac implications from analog viral respiratory pandemics;
• Early cardiac implications from case reports on Wuhan Coronavirus; and
• Background on Coronavirus epidemic.
The bulletin was reviewed and approved by the ACC Science and Quality Oversight Committee.
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